Action and training close the door to litigation

Jeffrey S. Willmann

Rarely does an accident occur at a convenient time or place. How many times has a coach operator answered a call at the worst possible time of the day or night from a driver reporting an accident?

Understandably no one can predict when or where something will go wrong; it is precisely why the entire organization must be prepared 24/7 for when an accident can occur at any time. The team must know to immediately report an accident of any degree and respond with decisive action based on training.

The process must include the operator contacting the insurer immediately. Liability can hinge on the account of the facts from only one witness or passenger. The investigative team must receive all relevant facts to the accident.  Preserving as much information possible in the early moments is critical, such as the driver’s version of what happened, as well as the names and phone numbers of witnesses and key individuals.

Lancer Insurance recommends its accident kit for accurately reporting a claim. Placed in a convenient easy to reach place in the vehicle it includes courtesy cards to obtain names, addresses and contact information of all passengers, other drivers and company personnel and witnesses at the scene. Lancer suggests taking photos and even provides an AccidentCam in the kit — with the reminder to only photograph the vehicles involved and the accident scene, and to never photograph an injured individual.

Case study one

In May 2008 mechanical problems disabled a coach returning from Las Vegas. The driver pulled onto the shoulder six feet off the three-lane highway to investigate. On this hot night the driver instructed his passengers to remain on the bus and then deboarded to set out flares and warning triangles on this unlit portion of the highway. Several passengers became overheated and exited the coach before the driver returned.

As traffic approached the disabled vehicle one intoxicated driver failed to notice the slowing traffic in time and lost control of his automobile. He slid off the roadway and struck one of the coach passengers standing off the highway 100 feet from the coach.

Neither the driver nor the company reported this accident to Lancer. Because there was no impact to the coach they did not think their company was involved in any way. The driver did not take photographs to show the coach was clearly off the roadway.

When the claims examiner received the report two years later, he was unable to obtain a complete passenger list and therefore unable to follow up with witnesses. By that time the driver was no longer with the company and thereby uncooperative with the examiner.

The passenger struck by the out of control vehicle sustained injuries and ultimately filed a lawsuit against the drunk driver and the coach company. The jury determined both parties were at fault. The panel faulted the coach company for poor maintenance and the driver for not controlling the accident scene and for not asking passengers to stay off the roadway. Because he was uncooperative with a weak memory, he proved to be a very bad witness.

This claim might have turned out much differently had the driver and company notified Lancer immediately and taken the time from the start to fully document the scene, obtain witnesses and report the claim. Instead it resulted in an adverse verdict.

Case study two

A motorcoach pulled up behind two automobiles to wait to pick up high school students after a football game. As the driver eased forward with her foot still on the brake, a fight broke among a group of students near the front of the coach.

Distracted by the commotion, she allowed the coach to roll into the car ahead, pushing it into an SUV parked in front that vehicle. The vehicle sustained minimal damage front and rear and the driver was uninjured. The SUV went unscathed though the driver and adult passenger exited complaining of neck injuries.

The coach driver confirmed no one needed immediate medical treatment and used the Lancer AccidentCam for close-ups of the positions and damage to the vehicles involved. She spoke to the involved parties and obtained their contact information; completed a passenger list of the students on her coach, and immediately called Lancer.

The claims examiner noted that despite the fact the SUV driver and passenger claimed injury, they refused medical treatment at the accident scene. The photographs documented the very low impact accident with minimal damage to the car and none to the SUV.

He contacted the passengers on the bus who confirmed the impact was insignificant, suggesting only the slightest chance of injury.

As the claim process progressed, Lancer order surveillance on the SUV driver and passenger when they continued to seek frequent medical treatment. That action revealed the claimants were active and exhibited no outward signs of injury. The passenger worked at the doctor’s office where they were seeking treatment.

Following the report from the Lancer Special Investigations Unit and further questioning by the National Insurance Crime Bureau (NICB), the mother and son in the SUV ultimately withdrew their claims in the face of potential charges of insurance fraud.

While the liability was adverse for the driver, she handled her situation professionally, obtained all the necessary information and assisted with the investigation and defense of this claim, which greatly minimized its cost.

Lancer safety director Bob Crescenzo says the simple but most significant difference between these two incidents is one driver reported the claim, while one did not.

“The thought that there was no motor vehicle content or crash and therefore no incident or claim is simply incorrect,” says Crescenzo. “Every driver must be trained to recognize that anything that happens within the vicinity of the coach should be reported to the company and its insurance company.”

He says in the first scenario the two-year gap between the accident and the claim seriously compromised the opportunity to defend the policyholder, even when the driver had proceeded correctly.

The second scenario serves as an excellent example of what can happen when a driver maintains control of the situation and gathers the necessary information for a complete and accurate claims investigation.

“To keep the message simple: every driver must report every incident or crash,” says Crescenzo. “Gather as much information and evidence as possible. Even in the smallest events this practice is a hedge against their growing much larger at a later date.”

Jeffrey S. Willmann serves with Lancer Insurance as vice president, claims.